2003年至2013年期间尼日利亚无人在场分娩的趋势。
Trends in delivery with no one present in Nigeria between 2003 and 2013.
作者信息
Austin Anne, Fapohunda Bolaji, Langer Ana, Orobaton Nosakhare
机构信息
Maternal Health Task Force, Harvard TH Chan School of Public Health, Boston, MA, USA.
John Snow, Inc., Boston, MA, USA ; USAID Targeted States High Impact Project, Washington, DC, USA.
出版信息
Int J Womens Health. 2015 Apr 7;7:345-56. doi: 10.2147/IJWH.S79573. eCollection 2015.
PURPOSE
Skilled attendance at birth is a proven intervention to improve maternal and newborn health outcomes. Unfortunately, in Nigeria there are many women who give birth alone, with no one present (NOP). The purpose of this study was to document trends in women delivering with NOP between 2003 and 2013, and to identify the characteristics of women who are engaging in this risky practice.
METHODS
We utilized pooled data sets from the 2003, 2008, and 2013 Nigerian Demographic and Health Surveys. Married women, who had given birth in the 5 years before each survey were included, resulting in a sample size of 38,949 women. We used logistic regression to assess the unadjusted and adjusted odds of a woman delivering with NOP over time, by socio-demographic characteristics.
RESULTS
Prevalence of delivery with NOP in Nigeria declined by 30% between 2003 and 2013. The largest declines occurred in Sokoto State, where the number of women giving birth with NOP declined by almost 100% between 2003 and 2013. In the North West of the country, however, there was a 27% increase in the number of women giving birth alone over this time period. Older, poorer, less educated, higher parity, Muslim women residing in the Northern regions were significantly more likely to give birth with NOP. Women, who were involved in decisions surrounding their own health, and who had accessed antenatal care were significantly less likely to give birth with NOP.
CONCLUSION
Although there have been improvements in Nigeria's Maternal Mortality Ratio since 1990, recent estimates suggest a stagnation in this trend. One reason for this protracted decline may be lack of access to skilled delivery care. The 2013 national prevalence of Nigerian women giving birth with NOP was 14%, equivalent to over 1 million births in 2013. Nigeria must implement interventions to ensure every woman's timely access to, and use of skilled care to reduce preventable maternal mortality and morbidity.
目的
分娩时获得专业护理是一项经证实的可改善孕产妇和新生儿健康结局的干预措施。遗憾的是，在尼日利亚，有许多妇女独自分娩，无人在场。本研究的目的是记录2003年至2013年间无人在场分娩的妇女的趋势，并确定采取这种危险做法的妇女的特征。
方法
我们利用了2003年、2008年和2013年尼日利亚人口与健康调查的汇总数据集。纳入了在每次调查前5年内分娩的已婚妇女，样本量为38949名妇女。我们使用逻辑回归按社会人口学特征评估随着时间推移妇女无人在场分娩的未调整和调整后的比值比。
结果
2003年至2013年间，尼日利亚无人在场分娩的患病率下降了30%。降幅最大的是索科托州，2003年至2013年间，该州无人在场分娩的妇女人数下降了近100%。然而，在该国西北部，这一时期独自分娩的妇女人数增加了27%。年龄较大、较贫困、受教育程度较低、多胎、居住在北部地区的穆斯林妇女无人在场分娩的可能性显著更高。参与自身健康决策且接受过产前护理的妇女无人在场分娩的可能性显著更低。
结论
尽管自1990年以来尼日利亚的孕产妇死亡率有所改善，但最近的估计表明这一趋势出现了停滞。这种长期下降的一个原因可能是缺乏获得专业分娩护理的机会。2013年尼日利亚妇女无人在场分娩的全国患病率为14%，相当于2013年超过100万例分娩。尼日利亚必须实施干预措施，以确保每位妇女都能及时获得并利用专业护理，以降低可预防的孕产妇死亡率和发病率。
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